Denial Isn’t Just a River in Egypt

 

Several months ago I wrote about the importance of planning ahead in the event that you’re no longer able to care for your companion animal. This week I want to extend that thought to point out the importance of monitoring whatever plan is chosen because in some cases, as is true in this story, end of life decisions for humans may begin long before the actual end of life and they often involve loss of control due to many forms of cognitive dysfunction. Often, as is true in this story, caregivers do not always consider the best interests of the animal involved and the results can be devastating. In telling the story I’m not going to use real names—of the people involved or the dog—because that would serve no useful purpose and my goal here is to offer lessons to be learned and to educate.

Louise is an elderly woman who wanted to adopt a big dog from a shelter, so three years ago she went to a local shelter with Mary, her Power of Attorney. She adopted Leon—a large, healthy, active, seven year-old dog that had been at the shelter awhile.

Louise suffered from dementia (already diagnosed when she adopted Leon) and eventually went to live at an assisted living/memory care facility. Leon went with her but it soon became clear to the staff that Louise was unable to care for him. The final straw was when Leon started peeing all over the facility because Louise was incapable of remembering to take him outside. As she apparently had been doing ever since she first adopted him, Louise fed Leon constantly and at one point he weighed 126.5 pounds. (A healthy weight for Leon is between 70-75 pounds.) Because Louise was unable to care for Leon and she was told that she had to find another place for him to live, Louise then hired (through her POA, Mary) Sheila to care for Leon.

It wasn’t long before Sheila’s neighbors became concerned about Leon’s welfare. He wasn’t allowed in the house and could be heard crying at the door. The yard wasn’t fenced so he was tied up outside or left to wander the neighborhood. He frequently had no water and wasn’t fed on a regular basis. Neighbors did what they could to help Leon, including talking to Sheila and calling Animal Control, but still he remained where he was. One neighbor in particular, Rose, even took Leon to the vet on one occasion, and finally was so worried about him she called Old Dog Haven to see if we would take him because he was clearly in bad shape.

It was explained to Rose that Leon needed to be surrendered by his legal owner before we could intervene. Eventually that happened and Leon went to live with Nancy, a very experienced ODH foster mom.

Since he’s been with Nancy, Leon has had multiple vet visits, which included blood work, x-rays and a complete physical exam. He’s also seen a dermatologist and an ophthalmologist. He’s being treated four times a day for all of his medical issues, is on a special diet and gets regular exercise to help him lose weight. (He now weighs 98.5 pounds.)

That’s the bare bones version of the story. This is what Leon’s foster mom has to say about Leon:

“After I picked Leon up at the vet hospital where he’d been brought by Mary I came home with a giant, very obese depressed dog that could barely walk, barely weight bearing when he did walk, could not rise on his own, could not go up any stairs, had huge skin lesions, itched all over, had swollen eyes from itching and rubbing, had draining tracts on the bottoms of his feet, and horribly inflamed ears—just for starters.

“Further vet visits show that Leon has low thyroid, severe arthritic change in his spine, and a mass in his abdomen—probably on the spleen or could be on the liver.

“Leon has been a struggle physically for me but Judith sent me a Help-Em-Up Harness and that has helped me lift him and get him moving. He has perked up and is more mobile already (especially with the harness), and I think once we get his thyroid supplemented, he may be even better. With all his new medications and treatments, Leon is starting to improve. He’s now able to get up on his own, and he goes out for an actual walk three times per day. He started at only being able to stand and move for ten minutes at a time, but now he’s up to 20-30 minutes. His skin is improving, the itching has become less, but is not resolved. Everything is a work in progress, and there is a very long road ahead.

“But the best thing is that he is no longer depressed. He wags his tail, smiles, tries to jump up in his excitement to go out for walkies, and loves to lay on the front porch with his Old Dog Haven family and watch the world go by. Leon has learned that this is his forever home, and now when he’s loaded in the car for yet another trip to the vet, he knows this is where he will come back to. If it were not for Old Dog Haven, Leon would still be somewhere in limbo suffering with his pain. This is a dog that REALLY needed someone to intervene for his final days.”

Ok, so now I’d like you to consider the lessons available to be learned from Leon’s story:

1. As I wrote in a previous blog, planning ahead in the event that you’re unable to care for your dog is very important. But, any kind of plan needs monitoring, especially if there are cognitive issues involved, and there needs to be an active support system in place.
2. Shelters need to carefully screen adoptions to senior citizens. In theory, adopting a senior dog to a senior human is a wonderful idea and is very often successful on many levels, but when an elderly person is mentally and legally unable to make decisions for herself, that should be a red flag.
3. People who serve as a POA for an elderly person with dementia (or anyone for that matter) really need to stay on top of the situation, especially if there’s an animal involved that needs care, medical attention and exercise.
4. If Assisted Living/Memory Care facilities are going to permit patients to have their animals live with them, they need to have a plan in place that involves staff members assuming responsibility for the care of animals that live there.
5. Keeping a dog outside 24/7 is inhumane and chaining a dog is totally unacceptable.
6. Dogs suffer the consequences of the actions (or in the case of Leon—lack of action) of people.
7. Having the financial resources to put a plan in place (hiring a POA, vet visits, etc.) isn’t enough if there’s no follow-through and instructions are followed.

Everyone involved with Leon before he came to ODH probably thought they were doing the right thing, including Louise, but denial about Leon’s physical, mental and emotional condition, and lack of medical care compromised his life in a significant way.

Please think about Leon if you become involved in any way in a similar situation.